Bocepreviralapú hármas kezelés hatékonyságának és biztonságosságának retrospektív elemzése előrehaladott fibrosisstádiumú, hepatitis C-vírus 1-es genotípussal fertőzött, korábban sikertelenül kezelt magyar betegeknél

INTRODUCTION: During 2011 and 2013, 155 Hungarian hepatitis C genotype 1 infected patients, mostly with advanced liver fibrosis, who did not respond to prior peginterferon + ribavirin dual therapy, started boceprevir based triple therapy in an early access program. AIM AND METHOD: Efficacy and safety of the therapy was retrospectively assessed based on sustained virologic responses, as well as on frequency and type of serious adverse events and of those leading to therapy discontinuation. RESULTS: In an intent-to-treat analysis 39.4% patients (61/155) reached sustained virologic response. Amongst pervious relapsers, partial responders and null-responders 59.5%, 41.4 % and 22.9% (p<0.05 compared to the other two categories) reached sustained virologic response, respectively, while amongst non-cirrhotics and cirrhotics 52.5% and 31.3% (p<0.05 compared to the non-cirrhotics) achieved sutained virologic response, respectively. Six out of the 33 most difficult to cure patients (previous null responder and cirrhotic) have reached sustained virologic response (18.2%). Frequency of early discontinuations due to insufficient virologic response was 31.1%, while due to adverse event 10.3%. Reported frequency of serious adverse event was 9.8%. These events represented anemia, diarrhoea, depression, agranulocytosis, elevated aminotransferases, generalized dermatitis and severe gingivitis with loss of teeth, prolonged QT interval on ECG, generalized oedema and severe dyspnoea, uroinfection, exacerbation of Crohn's disease, Campylobacter pylori infection and unacceptable weakness and fatigue. Eight patients received transfusion, 4 patients erythropoietin and 1 granulocyte colony stimulating factor during therapy. No death has been reported. CONCLUSIONS: With boceprevir based triple therapy, one of the bests available in 2011-2013 in Hungary, a relevant proportion of hepatitis C infected patients with advanced liver fibrosis achieved sustained viral response. In this cohort, side-effects resembled those reported in registration studies, and resulted in therapy discontinuation with consequent treatment failure in a relevant number of patients. Efficacy and tolerability of boceprevir-based triple therapy are suboptimal, particularly in the most difficult to cure patient population. Orv. Hetil., 2016, 157(34), 1366-1374

Комплексное изучение естественнонаучными методами и реставрация сумочки из Красногорского могильника = Comprehensive Study of Natural Science Methods and Conservation of a Handbag from Krasnogorskiy Burial Ground

The article presents the results of a multidisciplinary study of a unique artifact from burial 8 of the Krasnogorskiy ancient Mari burial ground of the X century – a leather purse/handbag with a metal plate on the cover. Handbags of this type are known in the Carpathian Basin, Eastern European region and even found on some Scandinavian burial grounds. Not only the metal plate has been preserved, but also large fragments of organic materials forming the details of the handbag, which allows us to restore the full appearance of the item. A comprehensive study of the handbag made it possible to make a complete reconstruction. At present, this is the only reconstruction of purses/handbags of the sabretache type from medieval burial grounds, made on the basis of analyses of organic and metal parts of the handbag obtained by specialists of various fields. The conservation of the object was carried out by applying the comprehensive study. A specialized study of the materials used in the manufacturing of the handbag allows to reveal a certain similarity with Hungarian handbags, but does not give reason to consider the handbag from the Krasnogorskiy burial ground as a complete copy of them. This article is the first experience of a comprehensive study of items of this type at the international level (Mari Research Institute of Language, Literature and History named after V.M. Vasilyev, Institute of Archaeology named after A.H. Khalikov, Pázmány Péter Catholic University). The results of the study are preliminary

Responses of diatoms to the Younger Dryas climatic reversal in a South Carpathian mountain lake (Romania)

A high-resolution paleolimnological study from Lake Brazi, a small mountain lake in the Southern Carpathian Mountains, Romania, shows distinct diatom responses to late glacial and early Holocene climate change between ca. 15,750 and 10,000 cal year BP. Loss-on-ignition, titanium, sulphur, phosphorus, biogenic silica content, and diatom assemblage composition were used as proxies for past environmental changes. Total epilimnetic phosphorus (TP) concentrations and lakewater pH were reconstructed quantitatively using diatom-TP and pH transfer functions. The most remarkable changes in the aquatic ecosystem were found at ca. 12,870 and 10,400 cal year BP. Whereas the onset of the Younger Dryas (YD) climatic reversal was conspicuous in our record, the beginning of the Holocene was not well marked. Two diatom assemblage zones characterize the YD in Lake Brazi, suggesting a bipartite division of this climatic oscillation. The diatom responses to the YD cooling were (1) a shift from Staurosira venter to Stauroforma exiguiformis dominance; (2) a decrease in overall diatom diversity; (3) a decrease in lake productivity, inferred from DI-TP, organic matter, and biogenic silica content; and (4) a lowering of the DI-pH. Compositional change of the diatom assemblages suggested a sudden shift towards more acidic lake conditions at 12,870 cal year BP, which is interpreted as a response to prolonged ice cover and thus shorter growing seasons and/or enhanced outwash of humic acids from the catchment. Taking into account the chironomid-based inference of only moderate July mean temperature decrease (<1 °C), together with the pollen-inferred regional opening of the forest cover and expansion of steppe-tundra, our data suggest that ecosystem changes in the Southern Carpathians during the YD were likely determined by strong seasonal changes